Using Video as a Medical Educational Resource

Just 2 days before writing this, I wrapped up a few hours earlier than usual from my clinic. Heading out for a weekend getaway? No, I was making the drive up to the University of California, San Diego (UCSD) campus, where I was slated to give a presentation.

On a Friday.

At 4:00 PM.

As the last speaker in a 4-hour retreat.

Actually, there was one last item on the agenda — I was slotted right before a brief university parking update, a sore topic if there ever was one. I am grateful I spoke before and not after that.

I was tasked with a sole, seemingly simple instruction: give an update on a medical education project I’ve been spearheading. Sounds glamorous, but this has been the epitome of a grassroots project. I started with no budget, no roadmap, and a team of 1, consisting of — you guessed it — yours truly. But here I was, about to share with my colleagues who each serve as a preceptor for a primary care clerkship with 1 third-year medical student assigned to them for the entire year. My main mission was to inspire individuals to contribute brief videos on topics for the students in their clerkships.

I opened up both PowerPoint and my e-mail (I managed to be able to embed a video I had made with the help of aspiring medical students, but essentially with only audio), and I pressed the “play” button.

Concept videos, or narrated animated videos, are not new. The Khan Academy  and TED talks are 2 examples of brief videos that educate and inspire. Stanford University School of Medicine in California has developed these as part of the “flipped classroom” for medical education. The flipped classroom involves asking students to view material that would usually be delivered in a lecture before class, and using that class time to engage actively — solving cases, answering questions, and the like.

What if we took this idea of making these short videos available for students to view, before, during, and/or after their rotations?

This concept has been examined in 3 studies.^1-3 Using videos in a surgical clerkship, educators at Stanford asked 89 third-year medical students about an approach that included viewing different brief (6-18 minute) videos. About 90% of the students supported continuing this curriculum, and 84% stated that this should be expanded to other clerkships.

Comments included: “It allowed us to learn the material at home at our own pace, which greatly helped me ‘get’ the learning points since I had time to look things up while watching the videos.” Another observed, “Absolutely out-of-the-box thinking with regard to clerkship education, wish other clerkships would follow example.”

Here are some advantages of this format.

Flexible for the student. Students can watch, rewind, and watch the videos again at any time. Conversely, they can move past parts of the video they are familiar with. This asynchronous nature of the video format is much appreciated. One of my students noted, “I like how I can go back and review something that [is] really tough for me to understand.”

Flexible for the preceptor. One of the questions from my colleagues was, “How much time would it take to make one of these videos?” The short answer? It varies, but can be relatively [short]. There is a great degree of flexibility here, too. You could decide to create a video as short as 3 minutes. Most tend to take no more than approximately 10 minutes, to preserve the advantages of this format. If you are drawing and/or writing on a whiteboard or a tablet, you could be finished in just a few minutes. Editing can add more time, depending on how much you do so, and your level of comfort with the process.

You can build a legacy of enduring material. This sentence gets to the core of why I love being an educator — being able to spark enthusiasm for learning in another individual. Beyond that, he or she can ask new questions and contribute to medical knowledge. Yes, I realize this sounds idealistic. But is that not part of why we became physicians in the first place? This streak is and should be wisely tempered with a counterbalancing dose of pragmatism over the years. Do we not want a degree of idealism in our physicians of tomorrow? In ourselves as well? Let’s use technology to create additional resources to facilitate learning.

Our chief and family medicine department heads offered their support for the concept. Several colleagues expressed enthusiasm and asked great questions. I am eager to see how this unfolds.

Here is an example of a video I created to help provide medical students with an approach to an outpatient clinic visit with a patient with diabetes: https://youtu.be/dyUqdFf2ILw

Have you or colleagues tried your hand at producing these videos? I invite you to please share any insights and tools you have found helpful in teaching.

Acknowledgments: I would like to heartily thank Steve Schneid, Joseph Ramsdell MD, David Bazzo MD, and Jess Mandel, MD, for their support and help. 

I would like to express my profound appreciation to Becca Dehnel, Laurel Ball, and Melanie Yoshihara, all from the UCSD Post-Baccalaureate Program, both for their time serving as patients in the videos and for their technical assistance.

References

1. Morgan H, Marzano D, Lanham M, Stein T, Curran D, Hammoud M. Preparing medical students for obstetrics and gynecology milestone level one: a description of a pilot curriculum. Med Educ Online. 2014;19:25746. doi:10.3402/meo.v19.25746
2. Belfi LM, Bartolotta RJ, Giambrone AE, Davi C, Min RJ. “Flipping” the introductory clerkship: impact on medical student performance and perceptions. Acad Radiol. 2015;22(6):794-801. doi:10.1016/j.acra.2014.11.003
3. Liebert CA, Mazer L, Merrell S, Lin DT, Lau JN. Student perceptions of a simulation-based flipped classroom for the surgery clerkship: a mixed-methods study. Surgery. 2016;160(3):591-598. doi:10.1016/j.surg.2016.03.034